Substance Use in a Sample of Medical Patients (Short Communication) (Report)
A number of the Iranian patients use substances such as opium and tobacco for therapeutic purposes. Opium was known to the ancient Persians and has been traditionally used for relieving pain, treating diseases and also for enjoyment. Drug abuse remains a crime in Iran, but the authorities are now willing for substance dependence to be treated as a psychiatric disorder. Substance abusers undergoing treatment are no longer prosecuted, nor are the specialists who are treating them. Costs of treatment, medication and rehabilitation are paid by patients according to the approved tariffs, but the government will pay the costs for those unable to afford treatment (Drug Control Headquarters 1997). Alcohol is prohibited both by religion and law. Other illicit substances include opium, heroin, morphine, cocaine, stimulants, LSD, cannabis, and hallucinogens. The State Welfare Organization, which is affiliated to the Ministry of Health, Treatment, and Medical Education, is in charge of treatment and rehabilitation of substance-dependent patients. At the present time, there are many treatment and rehabilitation centers in Iran, but in 1999 there were 12 treatment and rehabilitation centers in Iran, with one center specifically for women. Up until 1999, in four years approximately 25,000 to 30,000 individuals were admitted to these centers (90% of these referrals were ordered by courts; Razzaghi et al. 1999). The treatment was residential with the average duration of stay from two to six months. The centers were described as having the infrastructure of an overcrowded prison. Since that time outpatient treatment has been introduced and was initially based on detoxification with clonidine and tranquilizers, but more recently with buprenorphine or methadone. The usual duration of treatment is between three to six months, but on occasions it may be extended to two years. The treatment includes individual therapy, family therapy, and group therapy. Relapse rates are estimated to vary between 60% to 80%. Recently self-referral centers have developed across the country, as have Narcotic Anonymous groups, which now have approximately 5,000 members (Razzaghi et al. 1999).